Asinof: Positive Vibrations

On Wednesday, Oct. 17, Canada legalized the recreational use of marijuana, making it legal to buy, sell, smoke and ingest marijuana anywhere in Canada. In doing so, the country has embraced what is estimated to be a $6 billion-a-year adult use and sales market as a growth [pun intended] industry.

The biggest problem facing the new national market appears to one of managing supply, according to industry analysts.

Instead of the dropping of a crystal ball in Times Square, there was the dropping of a “bud” in Toronto to mark “the end of prohibition,” as Canadian Prime Minister Justin Trudeau described it. In Trudeau’s opinion, legalizing marijuana is a way to shut down the black market drug profiteers and cartels.

In making the use of recreational marijuana legal, Canada joins several U.S. states, including Massachusetts, Colorado, California, Nevada, Oregon and Washington, and the South American country of Uruguay.

What are the odds that the Canadian decision to end the prohibition against recreational marijuana could spur a new kind of trade and tourism imbalance with the U.S., one that tariffs cannot solve?

Extending medical marijuana for autism spectrum disorders

The day before recreational marijuana was made legal across Canada, the R.I. Department of Health announced that its decision to add autism spectrum disorder to the list of conditions that can be treated with medical marijuana in Rhode Island, provided that the patient’s physician takes a number of steps.

These include:

Other medications containing pure extracts of CBD, or cannabidiol, must be considered first, or the doctor must indicate why they are not being tried first.

The physician must first consult with a child psychiatrist or pediatric neurologist.

The physician must assess his or her pediatric patient with a child psychiatrist or pediatric neurologist three months after the initiation of medical marijuana.

And, medical marijuana treatment must be discontinued if it is not benefiting the patient.

The Massachusetts dilemma

Despite voters overwhelmingly approving legalizing recreational marijuana in November of 2016, some two years later, the Commonwealth of Massachusetts has struggled with the implementation of the law. Translated, elected officials have found it difficult to figure how to put their own bureaucrats in charge of the bureaucracy, according to many critics of the slowness of the process.

The California buzz

One of the biggest developing markets for recreational marijuana is not younger people but older residents with issues around chronic pain. Many of the facilities selling marijuana have offered free transportation to residents of senior centers where they can purchase products.

As NPR reported in a recent story, among the fastest growing group of users are people over 50, with especially steep increases among those 65 and older. The story recounted how a free shuttle, known as the “Cannabus,” transported about 35 seniors from Laguna Woods Village, a retirement village, to a licensed cannabis dispensary in Santa Ana, Calif., known as Bud and Bloom.

As of March 2018, AARP reported that in Colorado, people 50 and older now make up more than 36 percent of patients on the medical marijuana registry.

Translated, instead of buses scooping up seniors for a day at a Native American resort gambling complex, many seniors are choosing to go shopping at cannabis dispensaries.

Where is Rhode Island in the mix?

It is unclear where Rhode Island is in the process of legalizing recreational use of marijuana. While it has moved aggressively to try and counteract the potential loss of gambling revenue from casino expansion in Massachusetts, the efforts to legalize marijuana, despite efforts by some members in the R.I. General Assembly, have been thwarted in large part of House Speaker Nicholas Mattiello, according to a number of observers.

With Mattiello’s seat in apparent jeopardy in the 2018 elections, with another strong challenge by Republican candidate Steven Frias, it is unclear how legislative efforts to legalize recreational marijuana will proceed if Mattiello loses and a new House Speaker is chosen. Also, it is unknown what the position of the new apparent Rhode Island Attorney General Peter Neronha will be.

The position of Sen. Joshua Miller, chair of the Senate Health and Human Services Committee, and a strong proponent of the legalization of recreational marijuana, may be strengthened in the next session of the R.I. General Assembly.

The role of corporations

If the ongoing epidemic of opioid overdose deaths has taught us anything, it is the complicit nature of drug manufacturers, drug distributors and many physicians in advocating for the implementation of the pain scale as being considered a fifth vital sign and, in turn, the way that prescription painkillers were unscrupulously marketed as not being addictive.

As efforts in Rhode Island have progressed over the last six years in intervening and preventing drug overdose deaths, there is a growing realization that there are underlying issues that need to be addressed – including health disparities, economic disparities and mental and behavioral issues. The largest demographic for overdose deaths in Rhode Island in 2017 were people between the ages of 25-34, which correlates with the findings of mortality statistics for deaths from alcohol, suicide and drugs in Rhode Island, according to CDC statistics.

The reality is that we are not going to Narcan, or to arrest, or to treat our way out of this public health crisis. Yes, addiction is a disease, recovery is possible, but it is a long-term process, dependent on creating a sense of connectedness with community. It is not just about “recovery from” means, but rather visualizing what “recovery toward” means.

Image vs. reality

Much of the fears stoked over the legalization of marijuana have focused on the potential for young people to gain access and use and abuse marijuana, voicing concerns that it will become a stepping-stone on the road to using “harder” drugs.

However, the evidence to date from those states that have legalized recreational marijuana seems to suggest that there is much different demographic that is taking advantage of the new market: people who are 50 years or older.

Alcohol and tobacco, both legal for adult sales, regulated and taxed, have proven to have a far more lethal outcome related to addiction, public health outcomes and disease than marijuana – including growing medical costs.

Lessons from prohibition

Moving forward, there are plenty of lessons to be learned from the U.S. experience with prohibiting liquor.

Distilleries in Canada, include Seagram’s, profited handsomely from Prohibition in the U.S., including partnerships with illegal liquor distributors involving numerous organized crime families and allegedly some political connected families, too, such as Joseph Kennedy’s.

Perhaps, as Peter Tosh once sang, “Legalize it; then we’ll advertise it,” will become the new corporate mantra.

Of course, there are also research opportunities to discover the potential healing properties of associated with the use of marijuana, which will require the federal government to change the classification of marijuana away from Schedule One substance.

Richard Asinof is an award-winning journalist who frequently writes about health, innovation, science, technology and community in Rhode Island. He is the founder and editor of ConvergenceRI, an online newsletter offering news and analysis at the convergence of health, science, technology and innovation in Rhode Island. He can be reached at RichardAsinof@gmail.com.